• S Sehmisch, J Rieckenberg, and K Dresing.
• Abteilung Unfallchirurgie, Plastische und Wiederherstellungschirurgie, Universitätsmedizin Göttingen, Robert-Koch-Strasse 40, 37075, Göttingen, Deutschland. stephan.sehmisch@med.uni-goettingen.de
• Oper Orthop Traumatol. 2013 Feb 1; 25 (1): 63-83; quiz 83-4.

ObjectiveRestoration of function and anatomy of the proximal femur. Possibility of full weightbearing after surgery. Less invasive intramedullary osteosynthesis.IndicationsUnstable trochanteric fracture (AO classification 31-A2, 31-A3), subtrochanteric fracture (AO classification 32-A1), fracture of the femoral shaft in the proximal region.ContraindicationsIpsilateral coxarthrosis, open growth plate, hip fracture.Surgical TechniqueClosed or open reduction on the extension table. Intramedullary reaming of the proximal femur, insertion of PFNA and blade as proximal locking screw, static or dynamic distal locking screw. Implantion of bone cement via blade, if necessary.Postoperative ManagementWeightbearing as limited by pain. Osteoporosis diagnostics and initiation of treatment, if necessary.ResultsThe stabilization of trochanteric fractures is usually done with PFNA. Compared to other methods, e.g., DHS, fewer complications were observed with the PFNA. Subtrochanteric fractures were associated with higher complication rates compared to intertrochanteric fractures.

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